Don't overreact to threat of MRSA
Don't overreact to threat of MRSA
But don't let employees be needlessly exposed, either
Do you assume that employees with methicillin-resistant Staphylococcus aureus (MRSA) skin infections need to be routinely excluded from work? This is not necessary, according to Rachel Gorwitz, MD, MPH, a medical epidemiologist with the Centers for Disease Control and Prevention's Division of Healthcare Quality and Promotion.
"Exclusion from work, or from selected activities, should be considered for employees with skin infections only if they cannot keep their infected skin adequately covered during the activity in question," she says.
Once a problem solely for hospitals, MRSA has emerged in community strains that are often initially thought to be "spider bites" or boils. The employee must also adhere to appropriate wound care practices, including washing hands after dressing changes and disposing of used bandages appropriately. Employees with MRSA put others at risk if they have open, uncovered breaks or cuts in the skin, have frequent skin-to-skin contact, share personal items that could become contaminated with wound drainage, or fail to practice good hygiene.
"Employees working in environments where these factors are present would be at greatest risk of acquiring MRSA," says Gorwitz.
OHNs should use standard infection control precautions when seeing patients with skin infections, emphasizes Gorwitz.
This includes performing hand hygiene before and after patient contact, and using gloves, gowns, and/or eye protection for anticipated contact with wound drainage or other body fluids.
Gorwitz recommends taking these steps to prevent spread of MRSA in the workplace:
Educate employees on the signs and symptom of infection, and the importance of seeking care early for skin infections.
Review company policies regarding sick employees and return to work issues.
Instruct employees to keep cuts and scrapes clean and covered, avoid contact with other persons' wound drainage, and wash hands regularly.
Ensure availability of adequate soap and clean towels.
Educate employees on appropriate wound care and containment for infected skin.
Ensure that routine housekeeping in the workplace is followed.
Perform targeted cleaning of surfaces or equipment that are frequently touched by bare skin or that come into contact with infected skin.
Protect difficult-to-clean common use surfaces, such as computer keyboards, with covers that can easily be removed and cleaned.
A MRSA primer just for OCC health nurses
Occupational health nurses should be aware that methicillin-resistant Staphylococcus aureus (MRSA) is causing an increasing proportion of staph infections in the community, says Rachel Gorwitz, MD, MPH, a medical epidemiologist with the Centers for Disease Control and Prevention. Here are important facts to know:
Both "regular" staph aureus and MRSA skin infections typically appear as one or more red, swollen, painful bumps, sometimes with a white or yellow head or draining pus.
It's not possible to tell whether an infection is caused by MRSA or "regular" staph aureus by examination. You need to obtain a specimen for culture in order to distinguish these.
The most important treatment for purulent skin infections such as abscesses is draining the pus.
Antibiotics may be warranted in addition to drainage for some skin infections, depending on severity of local symptoms, presence of fever, and patient co-morbidities or immune suppression.
If you suspect MRSA and determine that antibiotics are warranted, choose an antibiotic that is typically active against the strains of MRSA circulating in your community.
Instruct employees with skin infections in wound care and containment to avoid spreading the infection to others. This includes keeping draining skin infections covered with clean, dry bandages, disposing of used bandages in the trash, washing hands frequently, and not sharing clothing or other personal items that could have become contaminated with wound drainage.
Source
For more information on methicillin-resistant Staphylococcus aureus in the workplace, contact:
- Rachel Gorwitz, MD, MPH, Medical Epidemiologist, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333. E-mail: [email protected].
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